Pre-operative oral nutritional supplementation with dietary advice versus dietary advice alone in weight-losing patients with colorectal cancer: single-blind randomized controlled trial.

BACKGROUND: Pre-operative weight loss has been consistently associated with increased post-operative morbidity. The study aims to determine if pre-operative oral nutritional supplements (ONSs) with dietary advice reduce post-operative complications. METHODS: Single-blinded randomized controlled trial. People with colorectal cancer scheduled for surgery with pre-operative weight loss >1 kg/3-6 months were randomized by using stratified blocks (1:1 ratio) in six hospitals (1 November 2013-28 February 2015). Intervention group was given 250 mL/day ONS (10.1 KJ and 0.096 g protein per mL) and dietary advice. Control group received dietary advice alone. Oral nutritional supplements were administered from diagnosis to the day preceding surgery. Research team was masked to group allocation. Primary outcome was patients with one or more surgical site infection (SSI) or chest infection; secondary outcomes included percentage weight loss, total complications, and body composition measurements. Intention-to-treat analysis was performed with both unadjusted and adjusted analyses. A sample size of 88 was required. RESULTS: Of 101 participants, (55 ONS, 46 controls) 97 had surgery. In intention-to-treat analysis, there were 21/45 (47%) patients with an infection-either an SSI or chest infection in the control group vs. 17/55 (30%) in the ONS group. The odds ratio of a patient incurring either an SSI or chest infection was 0.532 (P = 0.135 confidence interval 0.232 to 1.218) in the unadjusted analysis and when adjusted for random differences at baseline (age, gender, percentage weight loss, and cancer staging) was 0.341 (P = 0.031, confidence interval 0.128 to 0.909). Pre-operative percentage weight loss at the first time point after randomization was 4.1% [interquartile range (IQR) 1.7-7.0] in ONS group vs. 6.7% (IQR 2.6-10.8) in controls (Mann-Whitney U P = 0.021) and post-operatively was 7.4% (IQR 4.3-10.0) in ONS group vs. 10.2% (IQR 5.1-18.5) in controls (P = 0.016). CONCLUSIONS: Compared with dietary advice alone, ONS resulted in patients having fewer infections and less weight loss following surgery for colorectal cancer. We have demonstrated that pre-operative oral nutritional supplementation can improve clinical outcome in weight losing patients with colorectal cancer

Fibers are not (P)Threads: The Case for Loose Coupling of Asynchronous Programming Models and MPI Through Continuations

Asynchronous programming models (APM) are gaining more and more traction, allowing applications to expose the available concurrency to a runtime system tasked with coordinating the execution. While MPI has long provided support for multi-threaded communication and non-blocking operations, it falls short of adequately supporting APMs as correctly and efficiently handling MPI communication in different models is still a challenge. Meanwhile, new low-level implementations of light-weight, cooperatively scheduled execution contexts (fibers, aka user-level threads (ULT)) are meant to serve as a basis for higher-level APMs and their integration in MPI implementations has been proposed as a replacement for traditional POSIX thread support to alleviate these challenges. In this paper, we first establish a taxonomy in an attempt to clearly distinguish different concepts in the parallel software stack. We argue that the proposed tight integration of fiber implementations with MPI is neither warranted nor beneficial and instead is detrimental to the goal of MPI being a portable communication abstraction. We propose MPI Continuations as an extension to the MPI standard to provide callback-based notifications on completed operations, leading to a clear separation of concerns by providing a loose coupling mechanism between MPI and APMs. We show that this interface is flexible and interacts well with different APMs, namely OpenMP detached tasks, OmpSs-2, and Argobots.Comment: 12 pages, 7 figures Published in proceedings of EuroMPI/USA '20, September 21-24, 2020, Austin, TX, US

Everything as a Resource: Foundations and Illustration through Internet-of-Things

This paper presents Everything-as-a-Resource (*aaR) as a paradigm for designing collaborative applications on the Web. Abstracting these applications’ various physical and logical entities, resources are defined in a way that permits their discovery, composition, and participation in business scenarios. Compared to Everything-as-a-Service (*aaS), resources are categorized into computational, consumed, and produced, have trackable lifecycles as per their respective category, and are customized in order to consider the characteristics of future resource-based collaborative applications to develop. From a capacity perspective, a computational resource processes data, a produced resource abstracts data, and a consumed resource captures data. Along with their capacities, resources expose methods that other resources and/or applications’ stakeholders call. The proper call of methods is ensured through restrictions like limited and non-shareable. This paper exemplifies the *aaR paradigm with a case study that revolves around the use of Internet-of-Things (IoT) in the healthcare domain. The case study is implemented in a RESTful fashion along with some standard Web technologies and protocols. The evaluation of IoTR4HealthCare system is benchmarked against two existing systems using cost and latency criteria

Self-archiving and the Copyright Transfer Agreements of ISI-ranked library and information science journals

A study of Thomson-Scientific ISI ranked Library and Information Science (LIS) journals (n = 52) is reported. The study examined the stances of publishers as expressed in the Copyright Transfer Agreements (CTAs) of the journals toward self-archiving, the practice of depositing digital copies of one\u27s works in an Open Archives Initiative (OAI)-compliant open access repository. Sixty-two percent (32) do not make their CTAs available on the open Web; 38% (20) do. Of the 38% that do make CTAs available, two are open access journals. Of the 62% that do not have a publicly available CTA, 40% are silent about self-archiving. Even among the 20 journal CTAs publicly available there is a high level of ambiguity. Closer examination augmented by publisher policy documents on copyright, self-archiving, and instructions to authors reveals that only five, 10% of the ISI-ranked LIS journals in the study, actually prohibit self-archiving by publisher rule. Copyright is a moving target, but publishers appear to be acknowledging that copyright and open access can co-exist in scholarly journal publishing. The ambivalence of LIS journal publishers provides unique opportunities to members of the community. Authors can self-archive in open access archives. A society-led, global scholarly communication consortium can engage in the strategic building of the LIS information commons. Aggregating OAI-compliant archives and developing disciplinary-specific library services for an LIS commons has the potential to increase the field\u27s research impact and visibility. It may also ameliorate its own scholarly communication and publishing systems and serve as a model for others

Critique of deinstitutionalisation in postsocialist Central and Eastern Europe

In this paper, we explore critically deinstitutionalisation reform, focusing specifically on the postsocialist region of Central and Eastern Europe (CEE). We argue that deinstitutionalisation in postsocialist CEE has generated re-institutionalising outcomes, including renovation of existing institutions and/or creation of new, smaller settings that have nevertheless reproduced key features of institutional life. To explain these trends, we first consider the historical background of the reform, highlighting the legacy of state socialism and the effects of postsocialist neoliberalisation. We then discuss the impact of ‘external’ drivers of deinstitutionalisation in CEE, particularly the European Union and its funding, as well as human rights discourses incorporated in the UN Convention on the Rights of Persons with Disabilities. The analysis is supported by looking at the current situation in Hungary and Bulgaria through recent reports by local civil society organisations. In conclusion, we propose some definitional tactics for redirecting existing resources towards genuine community-based services